UNIVERSITY OF SAN CARLOS

SCHOOL OF LAW AND GOVERNANCE

CENTER FOR LEGAL AID WORK (CLAW)
P. Del Rosario and Pelaez Sts., Cebu City 6000

I.D.
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APPLICATION FORM
Personal Information:
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Name (Surname, Given Name, Middle Name)
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Email Address

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Nickname

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Year Level & Room No.

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Net chat account: (YM, etc)

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Mobile Number/s

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City Address

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Telephone No.

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Home Address

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Telephone No.

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Age

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Civil Status

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Birthday

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Father's Name

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Occupation

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Mother's Name

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Occupation

________________
Religion

Languages/ Dialects Spoken:____________________________________________________

Special Skills/ Interests:________________________________________________________
Health-related Information:
Allergies:____________________________

Phobias:________________________________________

Illnesses:_____________________________________

Other Health Considerations:____________________________________________

Food Restrictions:__________________________________________________________
Person to contact in case of emergency
Name:__________________________________________________________________
Address:_________________________________________________

Relation:_____________________________________________

Contact No. _________________________________________

Alternative Law Advocacies: Please check the appropriate space/s.

_____Women Rights
_____Children Rights
_____Environmental Protection

_____Human Rights
_____Indigenous People
_____Other, please specify: ______________________________________

Reason/s for joining CLAW

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I hereby certify that all the foregoing statements are true, complete and correct.

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Applicant's Signature and Date